Emotional effects of brain injury Emotional effects of brain injury affect how a brain injury survivor feels about things.

They can be organic (caused by damage to parts of the brain that control emotions), or due to living with the impact of brain injury. Emotional effects of brain injury are not often visible to others, unless shown through the survivor’s behaviour (see Behavioural effects of brain injury).

While people can make a good recovery after brain injury, many people have long-term emotional effects. Learning to use techniques that help with managing emotions can sometimes be beneficial, as well as using equipment or adaptations for other effects of brain injury that may be causing the difficult emotions.

Living with the effects of brain injury may cause many people to feel like they are ‘living life in the slow lane’ and this can be upsetting or difficult to adjust to. Quality of life or sense of identity can be affected by the emotional effects of brain injury. Speak to your GP, neurologist, or neuropsychologist about any emotional effects of brain injury that you are struggling with, as they may be able to prescribe medication or provide a referral to a specialist who can help.

Explore the sections below to find out more details about the emotional effects of brain injury.

What are the emotional effects of brain injury?

Click through the list below for information on some of the common emotional effects of brain injury.

Depression/ sadness

Depression and feelings of sadness are unfortunately common after brain injury, as there can be many changes in life after brain injury that can be difficult to adjust to. There may also be damage to parts of the brain responsible for emotional or hormonal regulation.

Depression can affect the survivor’s quality of life and can become a barrier to accessing support. It can also affect relationships and other important aspects of life.

Some people may have thoughts of self-harm or suicide. These thoughts can be distressing and difficult to manage. It can be helpful to have a plan for what to do when these thoughts occur (e.g., call a friend/ family member, have a planned activity you enjoy, and contact agencies that can support you). Help is available and you do not have to manage these thoughts and feelings alone. Even if you do not think that you will act on your thoughts, it is still helpful to speak with your GP or another medical professional about how you are feeling, so that support can be provided.

You can also text SHOUT to 85258, call the Samaritans or you can contact your local NHS urgent mental health helpline for help. The StayAlive App provides a resource with lots of useful information on how to stay safe in a crisis.

If you feel the need to self-harm or have already harmed yourself and need immediate assistance, call 999 or visit your local A&E department.

Anxiety/worry

Anxiety after brain injury is common and there are many possible reasons why brain injury survivors or their families/ carers may feel anxious after the injury. For instance, there may be damage to parts of the brain responsible for emotional or hormonal regulation, concerns over recovery and fears for the future, living with the effects of brain injury, changes in relationships, employment status or income, and circumstances surrounding the injury itself such as being treated in hospital.

Frustration and anger

Frustration and anger are internal, emotional states that in some cases can affect behaviour (aggression).  Feelings of frustration and anger are common after brain injury. Living with the effects of brain injury can be frustrating for the survivor, or there may be feelings of anger towards circumstances related to the injury (such as if the survivor was involved in a road traffic collision that wasn’t their fault). There may also be damage to parts of the brain responsible for emotional or hormonal regulation.

Brain injury survivors may get irritated or angry quicker than they did before their injury, or triggered by things that did not bother them before their injury.

Feelings of loss

The many changes that people can experience after a brain injury can often result in feelings of loss. This can be a loss of skills and abilities or activities the survivor is no longer able to do such as driving or working. For some, there can be a sense of changed identity which can be very difficult to cope with. People often report feeling like a ‘new person’ after their injury.

Post-traumatic stress disorder

After a brain injury, some people may experience post-traumatic stress disorder (PTSD). This is a severe psychological reaction to a traumatic event. It involves persistent re-experiencing of the trauma, avoidance of things that remind the person of the event (such as avoiding a certain location where an accident took place), increased arousal (quickened breathing, trembling, sweating), and a numbing of emotional responses.

PTSD is most commonly experienced following mild brain injuries. This is because in more severe forms of brain injury, there is often a loss of memories for the circumstances of the injury – for instance, many people fail to recall details of the exact moment they had a road traffic collision.

People can develop a fear of circumstances similar to that of their injury, and a small number of people have disturbing memories of the early stages of their recovery, for example when they were being treated in hospital.

Apathy

Apathy means having a loss of interest, motivation, or enthusiasm. A brain injury survivor may feel apathetic for many reasons. The parts of their brain involved in motivation may be affected. There may be depression or feelings of hopelessness about what the future may hold, especially in the earlier days of injury. Others may misinterpret the survivors’ apathy as disinterest, which can cause difficulties in relationships.

Feelings of apathy can be difficult to cope with, but there is life after brain injury and Headway is here to help.

Emotional liability

Control of emotions may be affected after brain injury so that emotions change rapidly or may seem exaggerated. They may be unpredictable or inappropriate, for instance, a person laughing at sad news.

Stress

Undergoing treatment, experiencing difficult life events, or having ongoing daily hassles can commonly cause stress after brain injury. Other common causes of stress include coping with the effects of brain injury, relationship changes, having one’s driving license taken away, managing a change in financial circumstances, dealing with a litigation case, expectations for recovery and returning to work.

Coping with stress requires many different cognitive functions to allow a person to recognise the symptoms, link the symptoms with a cause, form a coping strategy and control the emotions.

Issues with empathy

Being able to empathise with someone means being able to understand and appropriately respond to how they feel. Some survivors may lose their ability to recognise or understand others’ emotions. Relationships may be affected if family and friends misinterpret the lack of empathy as disinterest or the survivor being unfeeling.

Where can I get help with the emotional effects of brain injury?

It is a good idea to start by speaking to your GP about any issues you are having as they may be able to refer you to an appropriate service that can help. If you are under the care of a neurologist or rehabilitation team, they may be able to help with managing some of the emotional effects of brain injury.

Clinical neuropsychologists and clinical psychologists with experience in brain injury can often help with the emotional effects of brain injury. They will often begin by interviewing brain injury survivors and their families to get an understanding of what issues the survivor is experiencing. They may then complete tests or ‘mood screens’ to assess what emotional effects the survivor is experiencing. Coping strategies, talking therapies and lifestyle changes can be recommended to help cope with the emotional effects of brain injury.

Other professionals with experience in brain injury may also be able to help cope with the emotional effects of brain injury.

Talking therapies such as counselling may help to cope with some of the emotional effects of brain injury. Other forms of therapy offered by psychologists exist to help with emotional issues, such as cognitive behavioural therapy and compassion-focused therapy. Therapists will be able to advise which type of therapy is best suited depending on the emotional effects experienced. If possible, it is particularly helpful to find a counsellor who specialises in brain injury as they will be able to better understand experiences and use counselling techniques that might be more beneficial.  

There may be a service called IAPT (Improving Access to Psychological Therapies) in your area that allows you to access psychological therapy for issues such as depression and anxiety without needing a referral from your GP.

How do I cope with the emotional effects of brain injury?

Coping with the emotional effects of brain injury will depend on the types of effects you have. For some types of emotional effects, good support and understanding from family and friends can help. Share information from Headway with your loved ones to help them understand the effects of brain injury and how best to support you.

It is a good idea to start by speaking to your GP about any issues you are having as they may be able to refer you to an appropriate service that can help.

There may be psychological techniques that therapists can recommend and help you work through to redevelop emotional skills or learn how to cope.

Our freely accessible publications cover many of the effects of brain injury and can offer detailed information on coping tips.

When will I recover from the emotional effects of brain injury?

The emotional effects of brain injury may not be as obvious in the early days of injury and may be more apparent once the brain injury survivor has returned home or had time to process the brain injury. They may therefore take longer to understand and adjust to than some of the other effects of brain injury. Emotions may also change as the survivor begins to understand the impact that their injury has had on their life or adjust to life with brain injury.

While therapeutic intervention and good support from families and friends can sometimes help, emotional effects can last for weeks, months, or even years, and may require adaptations to cope.

No two experiences of brain injury are the same, so there are no rules about when you will recover from the emotional effects of brain injury. Receiving support from suitably qualified professionals can help with the recovery process while learning new ways of coping can help to readjust.

Remember you can get support for living with the effects of brain injury from your nearest Headway group or branch, or by contacting the Headway helpline.


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